Pub Date : 2025-04-03DOI: 10.1016/j.glmedi.2025.100191
Natasha Sood , Calista Long , Yuriy Pechenyy , Catherine Caldwell , Amanda Cooper , Andrew Geronimo
The United States healthcare sector is responsible for the highest proportion of carbon emissions attributable to any country. The objective of this study was to examine the attitudes of operating room (OR) personnel towards current waste production, energy use and recycling practices, knowledge of institutional policies, and perceived facilitators and barriers to enhancing sustainability in the OR environment. A cross-sectional survey of OR personnel was conducted at a single US academic tertiary care center to assess these perceptions of OR waste and its management. Questions targeted educational/workplace training in sustainable practices, knowledge of existing policies and their success, and ideas for future practices. Age, gender, role in the OR, and experience were collected, and survey responses were analyzed with use of descriptive statistics and testing for response differences by group. The survey responses of 190 individuals revealed that more than 80 % of respondents were unaware of institutional policies for OR sustainability despite most respondents having > 11 years of experience in the OR. If they were aware of sustainability policies, most respondents indicated that the energy saving programs and policies involving recycling and waste reduction were not implemented successfully and could be altered for more efficient use. Most respondents (92 %) indicated that they were willing to adopt new practices to achieve waste reduction in the OR, though one’s role in the OR appeared to influence these findings. Staff willingness to improve OR sustainability may enable the development of education and policies that support institution-scale change.
{"title":"Operating room personnel perspectives on sustainable practices in the operative environment","authors":"Natasha Sood , Calista Long , Yuriy Pechenyy , Catherine Caldwell , Amanda Cooper , Andrew Geronimo","doi":"10.1016/j.glmedi.2025.100191","DOIUrl":"10.1016/j.glmedi.2025.100191","url":null,"abstract":"<div><div>The United States healthcare sector is responsible for the highest proportion of carbon emissions attributable to any country. The objective of this study was to examine the attitudes of operating room (OR) personnel towards current waste production, energy use and recycling practices, knowledge of institutional policies, and perceived facilitators and barriers to enhancing sustainability in the OR environment. A cross-sectional survey of OR personnel was conducted at a single US academic tertiary care center to assess these perceptions of OR waste and its management. Questions targeted educational/workplace training in sustainable practices, knowledge of existing policies and their success, and ideas for future practices. Age, gender, role in the OR, and experience were collected, and survey responses were analyzed with use of descriptive statistics and testing for response differences by group. The survey responses of 190 individuals revealed that more than 80 % of respondents were unaware of institutional policies for OR sustainability despite most respondents having > 11 years of experience in the OR. If they were aware of sustainability policies, most respondents indicated that the energy saving programs and policies involving recycling and waste reduction were not implemented successfully and could be altered for more efficient use. Most respondents (92 %) indicated that they were willing to adopt new practices to achieve waste reduction in the OR, though one’s role in the OR appeared to influence these findings. Staff willingness to improve OR sustainability may enable the development of education and policies that support institution-scale change.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"6 ","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatocellular Carcinoma (HCC) stands as a formidable global health challenge, particularly in the context of chronic liver diseases, with significant associations to hepatitis B and C infections, alcohol misuse, and metabolic syndrome. The late-stage detection and complex treatment landscape have led to high mortality rates, necessitating innovative solutions. This review explores the emerging field of Nanotheranostics as a potent next-generation approach to combat HCC (Hepatocellular Carcinoma). The conventional diagnostic methods for Hepatocellular Carcinoma (HCC) present challenges in early detection, impacting treatment outcomes. Current imaging techniques, relying on criteria like arterial hyper-enhancement and delayed washout, exhibit limited sensitivity. Global variations in early detection rates further complicate therapeutic interventions. Nanotheranostics, an integration of diagnostic and therapeutic functionalities within nanoparticles, emerges as a promising solution. In diagnostics, Nanotheranostics utilizes diverse imaging modalities, such as MRI (Magnetic Resonance Imaging), CT (Computed Tomography), Positron emission tomography (PET), and optical imaging, providing a comprehensive view of HCC (Hepatocellular Carcinoma) tumors. Targeted imaging agents enhance specificity, enabling early detection without invasive procedures. Nanotheranostics significantly contributes to non-invasive monitoring and staging, offering a precise understanding of tumor heterogeneity and facilitating flexible treatment plans. In therapeutics, Nanoparticle-Based Drug Delivery Systems overcome biological barriers, ensuring efficient and targeted drug delivery. Carefully considering factors like size, shape, stability, biocompatibility, release kinetics, and targeting capabilities in nanoplatform design, the review emphasizes passive targeting effects and explores active targeting strategies using ligands. Combination therapy emerges as a potent strategy in Nanotheranostics, with observed synergistic effects in various drug combinations. Integration of immunotherapies like Nivolumab and Pembrolizumab with conventional drugs showcases promising results, with the STRIDE regimen and atezolizumab-bevacizumab becoming front-line standards. Nanotheranostics facilitates combination therapy, enhancing outcomes by addressing the complexities of HCC (Hepatocellular Carcinoma). Nanotheranostics represents a paradigm shift in HCC management, offering advanced diagnostic capabilities, precise monitoring, and innovative therapeutic interventions. Its ability to integrate multiple approaches within a single nanoplatform holds promise for improving patient outcomes in the challenging HCC landscape. This review underscores the urgent need for continued research and development in Nanotheranostics to harness its full potential in tackling Hepatocellular Carcinoma.
{"title":"Advanced nanotheranostic approaches for hepatocellular carcinoma management","authors":"Sachin Kothawade , Vijaya Padwal, Pranav Lodha, Vishal Pande","doi":"10.1016/j.glmedi.2025.100188","DOIUrl":"10.1016/j.glmedi.2025.100188","url":null,"abstract":"<div><div>Hepatocellular Carcinoma (HCC) stands as a formidable global health challenge, particularly in the context of chronic liver diseases, with significant associations to hepatitis B and C infections, alcohol misuse, and metabolic syndrome. The late-stage detection and complex treatment landscape have led to high mortality rates, necessitating innovative solutions. This review explores the emerging field of Nanotheranostics as a potent next-generation approach to combat HCC (Hepatocellular Carcinoma). The conventional diagnostic methods for Hepatocellular Carcinoma (HCC) present challenges in early detection, impacting treatment outcomes. Current imaging techniques, relying on criteria like arterial hyper-enhancement and delayed washout, exhibit limited sensitivity. Global variations in early detection rates further complicate therapeutic interventions. Nanotheranostics, an integration of diagnostic and therapeutic functionalities within nanoparticles, emerges as a promising solution. In diagnostics, Nanotheranostics utilizes diverse imaging modalities, such as MRI (Magnetic Resonance Imaging), CT (Computed Tomography), Positron emission tomography (PET), and optical imaging, providing a comprehensive view of HCC (Hepatocellular Carcinoma) tumors. Targeted imaging agents enhance specificity, enabling early detection without invasive procedures. Nanotheranostics significantly contributes to non-invasive monitoring and staging, offering a precise understanding of tumor heterogeneity and facilitating flexible treatment plans. In therapeutics, Nanoparticle-Based Drug Delivery Systems overcome biological barriers, ensuring efficient and targeted drug delivery. Carefully considering factors like size, shape, stability, biocompatibility, release kinetics, and targeting capabilities in nanoplatform design, the review emphasizes passive targeting effects and explores active targeting strategies using ligands. Combination therapy emerges as a potent strategy in Nanotheranostics, with observed synergistic effects in various drug combinations. Integration of immunotherapies like Nivolumab and Pembrolizumab with conventional drugs showcases promising results, with the STRIDE regimen and atezolizumab-bevacizumab becoming front-line standards. Nanotheranostics facilitates combination therapy, enhancing outcomes by addressing the complexities of HCC (Hepatocellular Carcinoma). Nanotheranostics represents a paradigm shift in HCC management, offering advanced diagnostic capabilities, precise monitoring, and innovative therapeutic interventions. Its ability to integrate multiple approaches within a single nanoplatform holds promise for improving patient outcomes in the challenging HCC landscape. This review underscores the urgent need for continued research and development in Nanotheranostics to harness its full potential in tackling Hepatocellular Carcinoma.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"6 ","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.glmedi.2025.100194
Ogochukwu Juliet Ezeigwe , Manali Desai , Olajumoke Ope Oladoyin , Ogochukwu Ruth Abasilim , Samuel Tobi Tundealao , Odinakachukwu Ogechi Dimgba , Temitope Rotimi Mamukuyomi , Maria E. Fernandez
Early detection of colorectal cancer (CRC) is crucial in reducing the associated morbidity and mortality. Our study aims to assess the association between obesity-cancer risk perception and the uptake of CRC screening among eligible adults in the United States. Additionally, we explored the variation of association stratified by gender. We analyzed data from the Health Information National Trends Survey (HINTS) 2018–2020. We performed descriptive statistics, bivariable, and multivariable logistic regression analysis. Of the 6435 overweight and obese US adults ≥ 45 years, 69 % (n = 4970) performed CRC screening. Approximately 85.4 % (n = 3243) of participants who believed that obesity increased the risk of cancer were screened. Perceived risk of obesity-related cancer was associated with 35 % significantly higher odds of screening (cOR:1.35,95 %CI:1.03–1.75). When compared to participants with no insurance, participants with health insurance had significantly higher odds of undergoing CRC screening (aOR:4.41,95 %CI:1.87–10.40). Non-Hispanic Black individuals had significantly higher odds of CRC screening compared to non-Hispanic White individuals (aOR: 2.17, 95 % CI: 1.04–4.51). For every one-year increase in age, there is an 11 % increase in screening (aOR:1.11,95 %Cl:1.07–1.16). There was no significant difference in CRC screening rates between males and females. Non-Hispanic Black females had significantly higher adjusted odds of CRC screening (aOR:3.17, 95 %CI:1.23–8.19) compared to non-Hispanic White females. Female college graduates had significantly higher odds of screening when compared to high school graduates (aOR:2.86,95 %CI:1.07–7.61). When compared to males who are non-smokers, former smokers had significantly higher odds of undergoing CRC screening (aOR:2.97,95 %CI:1.19–7.45). Male homosexuals/gay/lesbian when compared to heterosexual/straight males had significantly higher odds to be screened for CRC (aOR: 10.17,95 % CI:1.13–91.10). This study provided essential insights that help bridge gaps in cancer disparities, revealing that race/ethnicity and insurance status significantly impact CRC screening uptake. Health promotion programs should implement tailored interventions that emphasize perceived susceptibility to obesity and consider gender-specific factors to increase CRC screening rates.
{"title":"The role of obesity-risk perception and gender differences in colorectal cancer screening among eligible adults in the United States","authors":"Ogochukwu Juliet Ezeigwe , Manali Desai , Olajumoke Ope Oladoyin , Ogochukwu Ruth Abasilim , Samuel Tobi Tundealao , Odinakachukwu Ogechi Dimgba , Temitope Rotimi Mamukuyomi , Maria E. Fernandez","doi":"10.1016/j.glmedi.2025.100194","DOIUrl":"10.1016/j.glmedi.2025.100194","url":null,"abstract":"<div><div>Early detection of colorectal cancer (CRC) is crucial in reducing the associated morbidity and mortality. Our study aims to assess the association between obesity-cancer risk perception and the uptake of CRC screening among eligible adults in the United States. Additionally, we explored the variation of association stratified by gender. We analyzed data from the Health Information National Trends Survey (HINTS) 2018–2020. We performed descriptive statistics, bivariable, and multivariable logistic regression analysis. Of the 6435 overweight and obese US adults ≥ 45 years, 69 % (n = 4970) performed CRC screening. Approximately 85.4 % (n = 3243) of participants who believed that obesity increased the risk of cancer were screened. Perceived risk of obesity-related cancer was associated with 35 % significantly higher odds of screening (cOR:1.35,95 %CI:1.03–1.75). When compared to participants with no insurance, participants with health insurance had significantly higher odds of undergoing CRC screening (aOR:4.41,95 %CI:1.87–10.40). Non-Hispanic Black individuals had significantly higher odds of CRC screening compared to non-Hispanic White individuals (aOR: 2.17, 95 % CI: 1.04–4.51). For every one-year increase in age, there is an 11 % increase in screening (aOR:1.11,95 %Cl:1.07–1.16). There was no significant difference in CRC screening rates between males and females. Non-Hispanic Black females had significantly higher adjusted odds of CRC screening (aOR:3.17, 95 %CI:1.23–8.19) compared to non-Hispanic White females. Female college graduates had significantly higher odds of screening when compared to high school graduates (aOR:2.86,95 %CI:1.07–7.61). When compared to males who are non-smokers, former smokers had significantly higher odds of undergoing CRC screening (aOR:2.97,95 %CI:1.19–7.45). Male homosexuals/gay/lesbian when compared to heterosexual/straight males had significantly higher odds to be screened for CRC (aOR: 10.17,95 % CI:1.13–91.10). This study provided essential insights that help bridge gaps in cancer disparities, revealing that race/ethnicity and insurance status significantly impact CRC screening uptake. Health promotion programs should implement tailored interventions that emphasize perceived susceptibility to obesity and consider gender-specific factors to increase CRC screening rates.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"6 ","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Recent data shows a sharp rise in methamphetamine use, particularly among specific racial and ethnic groups, with higher rates in males and certain age groups, alongside varying impacts based on education and income levels. Till date, there remains dearth in the literature among New York State population. This study examined the sociodemographic factors associated with methamphetamine use and its impact on treatment outcomes.
Method
The Treatment Episode Dataset-Discharge (TEDS-D) from 2016 to 2020 were analyzed to investigate methamphetamine use, focusing on demographic variables. The analysis involved descriptive statistics, frequency distributions, and bivariate chi-square tests to explore relationships, as well as bivariate and multivariate logistic regression. All statistical analyses were conducted using SAS 9.4.
Results
10.84 % of participants were aged 12–24 years, while gender indicated a predominance of males, representing 73.44 % of the study population. Rehab patients have statistically significantly higher odds of methamphetamine use as than patients in Ambulatory/ Intensive Outpatient treatment (Adj OR- 1.21; 95 % CI- 1.15,1.26), while Detox patients have lower odds of using methamphetamine as than patients in Ambulatory, Intensive Outpatient treatment, however this was not statistically significant (Adj OR-0.35; 95 % CI- 0.11, 1.10). Intravenous drugs have 1.5 times higher odds of methamphetamine use as than non-intravenous drug use (Adj OR- 1.5; 95 % CI - 1.42, 1.54).
Conclusion
The study identified significant sociodemographic differences influencing methamphetamine use and treatment outcomes among this population. Addressing these factors with focused, culturally sensitive, and socio-economically mindful interventions can improve treatment effectiveness and aid recovery across diverse groups.
最近的数据显示，甲基苯丙胺的使用急剧上升，特别是在特定种族和族裔群体中，男性和某些年龄组的使用率较高，同时受教育程度和收入水平的影响也各不相同。到目前为止，在纽约州的人口中仍然缺乏文献。本研究调查了与甲基苯丙胺使用相关的社会人口因素及其对治疗结果的影响。方法分析2016 - 2020年治疗发作数据集-出院（TEDS-D），重点分析人口统计学变量，调查甲基苯丙胺的使用情况。分析包括描述性统计、频率分布和双变量卡方检验来探索关系，以及双变量和多变量逻辑回归。结果10.84 %的参与者年龄在12-24岁之间，性别以男性为主，占研究人群的73.44 %。康复患者使用甲基苯丙胺的几率显著高于门诊/门诊重症治疗患者(比值比= 1.21；95 % CI- 1.15,1.26)，而排毒患者使用甲基苯丙胺的几率低于门诊重症治疗患者，但这没有统计学意义(Adj or = 0.35；95 % ci - 0.11, 1.10)。静脉注射毒品使用甲基苯丙胺的几率是非静脉注射毒品使用的1.5倍(Adj OR- 1.5；95 % ci - 1.42, 1.54)。结论：该研究确定了影响该人群甲基苯丙胺使用和治疗结果的显著社会人口统计学差异。针对这些因素，采取有针对性的、文化上敏感的、注重社会经济的干预措施，可以提高治疗效果，帮助不同群体的康复。
{"title":"Methamphetamine use among substance use disorder treatment populations","authors":"Eniola Olatunji , Dalton James Bally , Oluwaseun Oke , Terence Tumenta , Ulunma Natalie Umesi , Vaibhav Vyas , Stanley Nkemjika","doi":"10.1016/j.glmedi.2025.100192","DOIUrl":"10.1016/j.glmedi.2025.100192","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent data shows a sharp rise in methamphetamine use, particularly among specific racial and ethnic groups, with higher rates in males and certain age groups, alongside varying impacts based on education and income levels. Till date, there remains dearth in the literature among New York State population. This study examined the sociodemographic factors associated with methamphetamine use and its impact on treatment outcomes.</div></div><div><h3>Method</h3><div>The Treatment Episode Dataset-Discharge (TEDS-D) from 2016 to 2020 were analyzed to investigate methamphetamine use, focusing on demographic variables. The analysis involved descriptive statistics, frequency distributions, and bivariate chi-square tests to explore relationships, as well as bivariate and multivariate logistic regression. All statistical analyses were conducted using SAS 9.4.</div></div><div><h3>Results</h3><div>10.84 % of participants were aged 12–24 years, while gender indicated a predominance of males, representing 73.44 % of the study population. Rehab patients have statistically significantly higher odds of methamphetamine use as than patients in Ambulatory/ Intensive Outpatient treatment (Adj OR- 1.21; 95 % CI- 1.15,1.26), while Detox patients have lower odds of using methamphetamine as than patients in Ambulatory, Intensive Outpatient treatment, however this was not statistically significant (Adj OR-0.35; 95 % CI- 0.11, 1.10). Intravenous drugs have 1.5 times higher odds of methamphetamine use as than non-intravenous drug use (Adj OR- 1.5; 95 % CI - 1.42, 1.54).</div></div><div><h3>Conclusion</h3><div>The study identified significant sociodemographic differences influencing methamphetamine use and treatment outcomes among this population. Addressing these factors with focused, culturally sensitive, and socio-economically mindful interventions can improve treatment effectiveness and aid recovery across diverse groups.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"6 ","pages":"Article 100192"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-29DOI: 10.1016/j.glmedi.2025.100190
R. Andrew Yockey
The recreational misuse of nitrous oxide has been increasing globally, with reports showing a rise from 10 % in 2015 to 20 % in 2021. In the United States, misuse has been steadily rising since 2010, and from 2023 to 2024, there was a 58 % increase in intentional nitrous oxide exposure reports. Small canisters marketed under names such as Galaxy Gas are often sold with minimal regulation, contributing to health risks, including oxygen deprivation, neurological damage, and even death. Nitrous oxide abuse can cause hypoxia, dizziness, unconsciousness, nerve damage, cognitive impairments, and fatal asphyxiation. The lack of regulation in its sale—especially for non-industrial and non-culinary purposes—has facilitated its widespread recreational use. Current legislation is insufficient, with loopholes allowing easy access, especially for young people. Stricter regulations, including age restrictions, licensing, and enhanced monitoring of online sales, are necessary to address this growing public health issue.
{"title":"Addressing the unregulated use of nitrous oxide canisters","authors":"R. Andrew Yockey","doi":"10.1016/j.glmedi.2025.100190","DOIUrl":"10.1016/j.glmedi.2025.100190","url":null,"abstract":"<div><div>The recreational misuse of nitrous oxide has been increasing globally, with reports showing a rise from 10 % in 2015 to 20 % in 2021. In the United States, misuse has been steadily rising since 2010, and from 2023 to 2024, there was a 58 % increase in intentional nitrous oxide exposure reports. Small canisters marketed under names such as Galaxy Gas are often sold with minimal regulation, contributing to health risks, including oxygen deprivation, neurological damage, and even death. Nitrous oxide abuse can cause hypoxia, dizziness, unconsciousness, nerve damage, cognitive impairments, and fatal asphyxiation. The lack of regulation in its sale—especially for non-industrial and non-culinary purposes—has facilitated its widespread recreational use. Current legislation is insufficient, with loopholes allowing easy access, especially for young people. Stricter regulations, including age restrictions, licensing, and enhanced monitoring of online sales, are necessary to address this growing public health issue.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"6 ","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-29DOI: 10.1016/j.glmedi.2025.100189
Diala Ra’Ed Kamal Kakish , Jehad Feras AlSamhori , Ahmad Ayman , Mohammed Al-Sawalha , Talin Hijazeen , Ruchira Clementina , Romaisa Ahmed , Noor Masadeh , Mohammad Al-Zuriqat , Amina Yahya Mohammed , Walid Al kurdi , Abdulqadir J. Nashwan
Amelanotic melanoma (AM) is a rare, yet aggressive melanoma subtype often overlooked due to its minimal pigmentation and atypical presentations. Conventional diagnostic tools, such as the “ABCDE” criteria and dermoscopy, frequently fail to detect AM in early stages, leading to delayed diagnoses and advanced disease. Advanced imaging techniques like reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) have improved detection accuracy, but underdiagnosis remains a significant challenge. Recent molecular insights, including TERT promoter mutations and BRAF/KIT alterations, have refined risk stratification and guided personalized treatments. However, immunoresistance and diagnostic complexity continue to hinder outcomes in advanced cases. Artificial intelligence (AI) offers transformative potential by addressing these gaps through its ability to analyze subtle vascular and morphological patterns often missed by clinicians. When integrated with molecular diagnostics, AI enables earlier detection, precise staging, and tailored therapeutic strategies. For instance, AI-powered tools can incorporate genetic and imaging data to predict treatment responses and optimize patient selection. Emerging approaches, such as SPION-functionalized CAR-T cells, liquid biopsies, and multimodal AI tools, promise further advancements in diagnostic precision and treatment efficacy. This review highlights the importance of combining AI with molecular diagnostics to achieve more precise, personalized, and equitable care for AM. Collaborative efforts among dermatologists and oncologists, and data scientists are essential to translate these innovations into practice and address disparities in outcomes for this challenging melanoma subtype.
{"title":"Amelanotic melanoma: Diagnostic challenges, treatment innovations, and the emerging role of in early detection","authors":"Diala Ra’Ed Kamal Kakish , Jehad Feras AlSamhori , Ahmad Ayman , Mohammed Al-Sawalha , Talin Hijazeen , Ruchira Clementina , Romaisa Ahmed , Noor Masadeh , Mohammad Al-Zuriqat , Amina Yahya Mohammed , Walid Al kurdi , Abdulqadir J. Nashwan","doi":"10.1016/j.glmedi.2025.100189","DOIUrl":"10.1016/j.glmedi.2025.100189","url":null,"abstract":"<div><div>Amelanotic melanoma (AM) is a rare, yet aggressive melanoma subtype often overlooked due to its minimal pigmentation and atypical presentations. Conventional diagnostic tools, such as the “ABCDE” criteria and dermoscopy, frequently fail to detect AM in early stages, leading to delayed diagnoses and advanced disease. Advanced imaging techniques like reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) have improved detection accuracy, but underdiagnosis remains a significant challenge. Recent molecular insights, including TERT promoter mutations and BRAF/KIT alterations, have refined risk stratification and guided personalized treatments. However, immunoresistance and diagnostic complexity continue to hinder outcomes in advanced cases. Artificial intelligence (AI) offers transformative potential by addressing these gaps through its ability to analyze subtle vascular and morphological patterns often missed by clinicians. When integrated with molecular diagnostics, AI enables earlier detection, precise staging, and tailored therapeutic strategies. For instance, AI-powered tools can incorporate genetic and imaging data to predict treatment responses and optimize patient selection. Emerging approaches, such as SPION-functionalized CAR-T cells, liquid biopsies, and multimodal AI tools, promise further advancements in diagnostic precision and treatment efficacy. This review highlights the importance of combining AI with molecular diagnostics to achieve more precise, personalized, and equitable care for AM. Collaborative efforts among dermatologists and oncologists, and data scientists are essential to translate these innovations into practice and address disparities in outcomes for this challenging melanoma subtype.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"6 ","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-20DOI: 10.1016/j.glmedi.2025.100187
Jagdish Khubchandani, Michael Wiblishauser, Fern J. Webb, R. Andrew Yockey, Kavita Batra
Skepticism and distrust towards medicine, science, and education have increased significantly over the past few decades in various regions around the globe. The COVID-19 pandemic has further exacerbated this mistrust, specifically leading to criticism of public health organizations. The pandemic revealed significant deficiencies in the structure, functions, and responsiveness of these organizations worldwide. As communities move into the post-COVID phase, there is an urgent need to reform public health organizations to enhance their services, strengthen their workforce, boost preparedness, and ensure equitable healthcare access for all. This commentary discusses the growing scrutiny of the role and importance of public health organizations, the necessity for their reform, and the key areas that require attention for meaningful reforms. By recognizing the need for change and implementing substantial reforms, public health organizations can be better prepared to tackle future health emergencies while fostering long-term health and well-being for populations.
{"title":"Reforming public health organizations in the post-COVID era","authors":"Jagdish Khubchandani, Michael Wiblishauser, Fern J. Webb, R. Andrew Yockey, Kavita Batra","doi":"10.1016/j.glmedi.2025.100187","DOIUrl":"10.1016/j.glmedi.2025.100187","url":null,"abstract":"<div><div>Skepticism and distrust towards medicine, science, and education have increased significantly over the past few decades in various regions around the globe. The COVID-19 pandemic has further exacerbated this mistrust, specifically leading to criticism of public health organizations. The pandemic revealed significant deficiencies in the structure, functions, and responsiveness of these organizations worldwide. As communities move into the post-COVID phase, there is an urgent need to reform public health organizations to enhance their services, strengthen their workforce, boost preparedness, and ensure equitable healthcare access for all. This commentary discusses the growing scrutiny of the role and importance of public health organizations, the necessity for their reform, and the key areas that require attention for meaningful reforms. By recognizing the need for change and implementing substantial reforms, public health organizations can be better prepared to tackle future health emergencies while fostering long-term health and well-being for populations.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"5 ","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-14DOI: 10.1016/j.glmedi.2025.100185
Taylor W. Young , Geoffrey Zhang , Linwood R. Haith Jr.
Dercum’s disease, alternatively known as adiposis dolorosa, is a rare condition characterized by multiple lipomas causing palpable skin defects associated with pain and tenderness. The prevalence and etiology of this disease remain unknown despite its debilitating impact on affected individuals. Current literature describes individuals with Dercum’s disease to be predominantly older, obese females. This report details a unique case involving a 29-year-old male who, between 2022 and 2024, underwent surgical excision of over 80 lipomas on five separate occasions. Prior to surgery, the nodules were assessed in an outpatient setting to determine their location, confirm skin changes, and evaluate their debilitating effects on the patient’s quality of life, thereby justifying the surgical approach. Histology proved all the lesions to be benign lipomas. Subsequent to the initial lipoma excisions, new lesions recurred on the torso and extremities. Differential diagnoses were considered such as neurofibromatosis, multiple familial lipomatosis, Madelung disease, Bannayan-Zonana syndrome, and Cowden syndrome were ruled out by family history, location of lesions, and histology. Although Dercum’s disease has been recognized since the late 1800s, advances in understanding and treating the condition have been limited. This case aims to shed light on the experience of a young patient with multiple recrudescent lipomas necessitating surgery.
{"title":"Dercum's disease: A unique case of recrudescent lipomas necessitating surgery","authors":"Taylor W. Young , Geoffrey Zhang , Linwood R. Haith Jr.","doi":"10.1016/j.glmedi.2025.100185","DOIUrl":"10.1016/j.glmedi.2025.100185","url":null,"abstract":"<div><div>Dercum’s disease, alternatively known as adiposis dolorosa, is a rare condition characterized by multiple lipomas causing palpable skin defects associated with pain and tenderness. The prevalence and etiology of this disease remain unknown despite its debilitating impact on affected individuals. Current literature describes individuals with Dercum’s disease to be predominantly older, obese females. This report details a unique case involving a 29-year-old male who, between 2022 and 2024, underwent surgical excision of over 80 lipomas on five separate occasions. Prior to surgery, the nodules were assessed in an outpatient setting to determine their location, confirm skin changes, and evaluate their debilitating effects on the patient’s quality of life, thereby justifying the surgical approach. Histology proved all the lesions to be benign lipomas. Subsequent to the initial lipoma excisions, new lesions recurred on the torso and extremities. Differential diagnoses were considered such as neurofibromatosis, multiple familial lipomatosis, Madelung disease, Bannayan-Zonana syndrome, and Cowden syndrome were ruled out by family history, location of lesions, and histology. Although Dercum’s disease has been recognized since the late 1800s, advances in understanding and treating the condition have been limited. This case aims to shed light on the experience of a young patient with multiple recrudescent lipomas necessitating surgery.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"5 ","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute lymphoblastic leukemia (ALL) is the most prevalent form of hematological cancer in children. In Bangladesh, the number of acute leukemia among children has been increasing each year and the genome studies regarding single nucleotide polymorphisms (SNP) in different genes related to lymphocyte development have not been explored yet. Therefore, the study aimed to examine the association between a specific SNP (rs10821936) in the ARID5B gene and the risk of childhood ALL in Bangladeshi children. The identification of the children's demographic and clinical characteristics as well as real-time PCR-based allelic discrimination method was employed to identify the genotypes of 194 ALL cases and 209 controls, respectively. Both the age difference and serum creatinine level between the control and patient groups were insignificant. In comparison to individuals who were healthy, both the blood ALT and LDH levels of the male and female child ALL participants were considerably high. However, compared to control groups, the serum calcium level in child ALL patients was considerably low. Serum ALT and LDH had a significant positive relationship while both had a negative correlation with serum calcium. The investigation revealed that the minor allele C was the risk allele for the SNP (rs10821936) and it has been linked to a higher incidence of ALL in Bangladeshi children [Odds ratio (OR) = 1.35; 95 % Confidence Interval (CI) = 1.02–1.79; P-value = 0.0380]. Thus, the findings of this study could help to understand the background of genetic predisposition and risk assessment of childhood ALL.
{"title":"Genetic polymorphisms in the chromatin modifier gene ARID5B in modulating the risk of pediatric acute lymphoblastic leukemia in Bangladesh","authors":"Farhana Jahan , Sajib Chakraborty , Mahrima Parvin , ATM Atikur Rahman , Zakir Hossain Howlader , Md. Ismail Hosen","doi":"10.1016/j.glmedi.2025.100184","DOIUrl":"10.1016/j.glmedi.2025.100184","url":null,"abstract":"<div><div>Acute lymphoblastic leukemia (ALL) is the most prevalent form of hematological cancer in children. In Bangladesh, the number of acute leukemia among children has been increasing each year and the genome studies regarding single nucleotide polymorphisms (SNP) in different genes related to lymphocyte development have not been explored yet. Therefore, the study aimed to examine the association between a specific SNP (rs10821936) in the <em>ARID5B</em> gene and the risk of childhood ALL in Bangladeshi children. The identification of the children's demographic and clinical characteristics as well as real-time PCR-based allelic discrimination method was employed to identify the genotypes of 194 ALL cases and 209 controls, respectively. Both the age difference and serum creatinine level between the control and patient groups were insignificant. In comparison to individuals who were healthy, both the blood ALT and LDH levels of the male and female child ALL participants were considerably high. However, compared to control groups, the serum calcium level in child ALL patients was considerably low. Serum ALT and LDH had a significant positive relationship while both had a negative correlation with serum calcium. The investigation revealed that the minor allele C was the risk allele for the SNP (rs10821936) and it has been linked to a higher incidence of ALL in Bangladeshi children [Odds ratio (OR) = 1.35; 95 % Confidence Interval (CI) = 1.02–1.79; <em>P</em>-value = 0.0380]. Thus, the findings of this study could help to understand the background of genetic predisposition and risk assessment of childhood ALL.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"5 ","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-27DOI: 10.1016/j.glmedi.2025.100183
Corey H. Basch, Helen Yousaf, Grace C. Hillyer
The proliferation of online pharmaceutical sales necessitates a deeper understanding of how medications such as the diabetes treatment Ozempic® are presented and marketed on Google Shopping, a major aggregator of e-commerce merchants. We analyzed the representation and characteristics of Ozempic® listings, which were provided as regular and sponsored product results, with options to filter by medication form (liquid, tablet, capsule, wipes), specific pain relief applications (e.g., migraine, arthritis), free shipping offers, and price ranges. Additional filters included selection by store, however no sorting or filtering criteria were applied to maintain neutrality in the initial data capture. The 57 results were vetted for duplication, relevance, and English language usage. The final sample analyzed included 19 unique URLs. Results indicated that pricing ranged between $65 for proprietary compounded semaglutides and other weight loss products and $1399.99 for Ozempic®. Nearly half of the vendors offered introductory discounts, while others offered payment plans; 21.1 % mentioned a money-back guarantee but insurance coverage received little attention. Nearly half of the websites (42.1 %) were sponsored by telemedicine platforms, 26 % by patient/weight loss services, and 21.1 % of these were pharmacies. To access these medications, 15 vendors (78.9 %) required a prescription and of these13/15 (86.7 %) could be provided through the vendor’s company physician after completing an online questionnaire. The majority of programs (94.7 %) were accessible remotely with no direct personal interaction with the company physician or supplier. Nearly 80 % of the websites mentioned the pros of the weight loss product they promoted compared to 68.4 % that mentioned any cons. Around one-third of the sites (36.8 %) made product safety claims and 10.5 % mentioned “testing” without any specific details, while just over one-half referenced the FDA (57.9 %) or cited research to support credibility (52.6 %). The reliance on online pharmacies for GLP-1 agonists highlights the need for safeguards to ensure consumer health and safety.
{"title":"Online purchasing options for GLP-1 agonists: Accessibility, marketing practices, and consumer safety concerns","authors":"Corey H. Basch, Helen Yousaf, Grace C. Hillyer","doi":"10.1016/j.glmedi.2025.100183","DOIUrl":"10.1016/j.glmedi.2025.100183","url":null,"abstract":"<div><div>The proliferation of online pharmaceutical sales necessitates a deeper understanding of how medications such as the diabetes treatment Ozempic® are presented and marketed on Google Shopping, a major aggregator of e-commerce merchants. We analyzed the representation and characteristics of Ozempic® listings, which were provided as regular and sponsored product results, with options to filter by medication form (liquid, tablet, capsule, wipes), specific pain relief applications (e.g., migraine, arthritis), free shipping offers, and price ranges. Additional filters included selection by store, however no sorting or filtering criteria were applied to maintain neutrality in the initial data capture. The 57 results were vetted for duplication, relevance, and English language usage. The final sample analyzed included 19 unique URLs. Results indicated that pricing ranged between $65 for proprietary compounded semaglutides and other weight loss products and $1399.99 for Ozempic®. Nearly half of the vendors offered introductory discounts, while others offered payment plans; 21.1 % mentioned a money-back guarantee but insurance coverage received little attention. Nearly half of the websites (42.1 %) were sponsored by telemedicine platforms, 26 % by patient/weight loss services, and 21.1 % of these were pharmacies. To access these medications, 15 vendors (78.9 %) required a prescription and of these13/15 (86.7 %) could be provided through the vendor’s company physician after completing an online questionnaire. The majority of programs (94.7 %) were accessible remotely with no direct personal interaction with the company physician or supplier. Nearly 80 % of the websites mentioned the pros of the weight loss product they promoted compared to 68.4 % that mentioned any cons. Around one-third of the sites (36.8 %) made product safety claims and 10.5 % mentioned “testing” without any specific details, while just over one-half referenced the FDA (57.9 %) or cited research to support credibility (52.6 %). The reliance on online pharmacies for GLP-1 agonists highlights the need for safeguards to ensure consumer health and safety.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"5 ","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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